Association of metabolic score for visceral fat with all‐cause mortality, cardiovascular mortality, and cancer mortality: A prospective cohort study

Abstract Aim Our study aimed to evaluate the association between the metabolic score for visceral fat (METS‐VF) and mortality. Methods We conducted a cohort study comprising 11,120 participants. We employed weighted multivariable Cox regression analysis to assess the relationship between METS‐VF and mortality. Restricted cubic spline analyses were used to investigate potential non‐linear associations. Receiver operating characteristic curves were used to evaluate the predictive value of METS‐VF and other obesity‐related indicators for mortality. Subgroup analysis and sensitivity analysis were performed to confirm the robustness of the results. Mendelian randomization analysis was utilized to assess potential causality. Results Over a median follow‐up duration of 83 months, a total of 1014 all‐cause deaths, 301 cardiovascular deaths, and 262 cancer deaths occurred. For every 0.2‐unit increase in METS‐VF, the hazard ratios(HRs) of all‐cause mortality, cardiovascular mortality, and cancer mortality were 1.13 [95% confidence interval (CI): 1.06, 1.20], 1.18 (95% CI: 1.06, 1.31), and 1.13 (95% CI: 1.03, 1.25), respectively. In addition, restricted cubic spline analyses revealed no significant non‐linear associations between METS‐VF and all‐cause mortality, cardiovascular mortality, and cancer mortality. In multivariate Cox regression models, hazard ratios of all‐cause mortality, cardiovascular mortality and cancer mortality were higher in the highest METS‐VF group compared to the reference group. Subgroup and sensitivity analyses confirmed that our results were robust. Receiver operating characteristic curves indicated that METS‐VF predicted mortality better than other obesity‐related indicators. Mendelian randomization analysis confirmed significant causal relationships. Conclusions METS‐VF was positively associated with all‐cause mortality, cardiovascular mortality, and cancer mortality. These findings suggest that METS‐VF could serve as a straightforward, reliable, and cost‐effective marker for identifying individuals at high risk of mortality.